Navy medics use battle experience to respond to emergencies at home in N.J.

John O'Boyle/The Star-LedgerFrank Dos Santos, a Navy emergency medicine physician, walks back to his vehicle (left) after treating a patient who was having seizures in North Brunswick. Dos Santos is part of a training program at Robert Wood Johnson Medical Center in New Brunswick.

By the time Frank Dos Santos arrived at the site of the car crash in Monroe Township last week, the accident scene was in chaos.

A bloodied pedestrian lay on Route 130 with severe head injuries. Two other victims were in a smashed car in need of help. Blood and glass were everywhere. A medical evacuation helicopter was on its way.

For Dos Santos, it was an eerily familiar scene. During an eight-month tour in Iraq two years ago, the Navy corpsman served in a shock trauma platoon, treating wounded Marines near the front lines.

Now, back in New Jersey, the emergency physician is using many of the same skills he learned in battle as a specialist in the emerging field of disaster medicine. At the Monroe accident scene, he quickly began coordinating various rescue crews and administered medications to stabilize the head trauma victim.

"We are finding that the way many of the injuries can be treated is the same," Dos Santos said. "What is working in Iraq can work in New Jersey to save lives, too."

Dos Santos, 39, is one of five fellows in the emergency medical services/disaster medicine program at Robert Wood Johnson University Hospital in New Brunswick. The highly-selective fellowship trains doctors in the best ways to treat patients at emergency scenes, from small car accidents to 9/11-style mass terrorist attacks.

Fellows in the unique program— which is co-sponsored by the University of Medicine and Dentistry of New Jersey — have published 20 scholarly papers, all looking at better ways to save the lives of patients before they reach the hospital.

Across the nation, more and more medical programs are requiring first responders to train in the growing field of disaster medicine, said Mark Merlin, medical director of the Robert Wood Johnson fellowship.

"It’s the whole country that is changing over and New Jersey is just a part of it," Merlin said.

While it is unclear how many combat veterans are training to be medical first responders, it is no doubt that their unique exposure to the chaotic and dangerous situations while treating victims in war makes them especially valuable in a civilian context, Merlin said.

They have a better awareness of their own safety in a dangerous situation and have experience working with multiple and severe injuries that first responders in a civilian context rarely see, Merlin said.

For Dos Santos, a disaster medicine fellowship was a natural fit after his tour in Iraq.

The Iselin resident earned a Navy scholarship in 1993 to become a military doctor. He went to medical school at UMDNJ in Stratford, then served as a Navy doctor in Italy for several years before he was deployed to Iraq.

The father of three spent most of 2008 traveling to hot spots in the war zone in one of the Marine’s dozen shock trauma platoons. The units are made up of Navy doctors, medical support teams and security personnel stationed near battlefields and military operations, waiting to immediately treat injured Marines and civilians. The sound of a roadside bomb explosion or a fire fight with suspected insurgents would often signal incoming injuries.

"They would go in and kick down doors, and I’d be staying out there with that kind of equipment, waiting for them," Dos Santos said.

The platoons have increased the survival rates of Marines in the Iraq and Afghanistan wars, said Vice Adm. Adam Robinson, the Navy Surgeon General.

"The key to this is having the capability to do major resuscitative surgery very close to the front lines to stabilize the patients so they can be evacuated," Robinson said.

Dos Santos said many of the same lessons can be applied to his emergency calls in New Jersey.

He has given photo presentations about his time in Iraq to more than a dozen gatherings of emergency medicine doctors in New Jersey, New York and Pennsylvania. He shows physicians examples of patients with massive bleeding and amputations, along with the techniques used to save them in Iraq.

In the last decade, methods of responding to mass casualties have evolved back home too, Dos Santos said. Radio communication has gotten better. Strategies to determine which injured victims should be evacuated first have change. Even methods of measuring blood loss at the scene have improved.

"Pre-9/11, when a disaster happens you just pick up the pieces and you run to the hospital," Dos Santos said. "But now it’s resource management — and it’s focused on communicating well with the fire department, the police department. It’s a whole field in itself."

Dos Santos never goes anywhere without his pager, an 800-megahertz radio and his SUV, so he is prepared to respond to any emergency.

His trunk contains a range of tools not carried in a regular ambulance, including powerful medications, equipment to detect carbon-monoxide levels, full surgical kits and chest tubes. He also carries a gas mask, helmet and fire-proof uniform for the most serious situations.

Most of Dos Santos’ calls aren’t mass disasters. On a recent Monday, he responded to the North Brunswick home of an elderly woman who had stopped breathing. It was one of several stops he would make that day responding to 911 calls, assessing patients and coordinating care between paramedics and emergency room doctors.

But even on an ordinary day, Dos Santos’ months as a battlefield doctor are never far from his thoughts. On the nights he arrives on the scene of a house fire or a fiery car accident, he can’t help but be reminded of the Marines he treated in Iraq.